Hypoglycaemia means low blood sugar. If your baby's blood sugar is low, and it is not treated, it could put his health at serious risk. If it stays low for a long time, it even could cause brain damage. However, if your baby is not premature, and otherwise healthy, he is unlikely to have low blood sugar.

Don't worry if he is at risk of having low blood sugar. A host of medical professionals will be on hand to make sure that your baby's health is safeguarded. After he's born, your paediatrician and other staff will make sure that he is feeding well. They will check your baby's glucose level with a blood test if they are worried. In some hospitals, these blood tests are routinely offered to babies who are thought to be at high risk.

What causes hypoglycaemia in newborns?

Every cell in the body needs a supply of sugar, or glucose, to function well. We get glucose from the foods we eat and newborn babies get it from milk. Keeping the right level of sugar in the blood is a delicate balancing act.

After we eat a meal, or when babies have just had a feed, sugar levels go up. When it is time for the next feed, levels start to dip. Sugar levels are regulated our hormones, particularly insulin, which helps certain cells take up glucose for storage. When everything is working well, the hormones keep the blood sugar levels within an even range. When the balance is out, hypoglycaemia can happen.

However, some babies are at risk, including babies born to mothers who have diabetes. They may produce too much insulin when they are born, making them prone to lower blood sugar levels.

Your baby's blood sugar levels go down in the first few hours after birth and this is normal. Most healthy babies can cope easily with normal dips in blood sugar level. If they're given breastfeeds whenever they want, they will take the milk they need to ensure their sugar levels remain healthy.

Babies are also susceptible to hypoglycaemia if they:

1) were born prematurely or very small;

2) had breathing difficulties at birth;

3) have suffered excessive coldness, or hypothermia;

4) have an infection.

5)Hypoglycemia in newborns can usually be reversed quickly. If it persists, your baby will need tests to find out what the underlying problem is.

How can I tell if my baby has hypoglycaemia?

Often, you can't tell just by watching your baby. But sometimes, if your baby's blood sugar is too low you may notice some subtle signs. He could be jittery or irritable – or very sleepy and floppy. When you are first getting to know your baby it's hard to know what is normal, so don't hesitate to ask your paediatrician to check him. Even if it is not hypoglycaemia, your baby could be ill for some other reason.

If your baby's blood sugar is very low, he could start fitting, or going into convulsions. These are signs that something very serious is happening and you'll need to get him to the hospital right away. Call an ambulance if you can't drive or there's no-one to drive you.. A blood test is the only way to find out for sure what your baby's sugar levels are. The usual way of testing is to take a pinprick of blood from the foot, and to test it either on the ward or in the hospital laboratory.

Each hospital has its own policy on testing. Doctors do not always agree on a safe level of blood glucose in a newborn baby. Too many tests may cause you needless worry. It could also make it harder to get breastfeeding started. Staff have to weigh this knowledge against the risk of missing a problem if they do not test your baby's blood.

What is the treatment?

You can encourage your newborn baby to feed frequently, especially if he is sleepy or not keen. This is easier to do if you are breastfeeding.

Sometimes it's difficult to get your baby to feed. At that point, the staff may say your baby needs expressed milk, which may be from a bottle, a cup or through a tube that goes down your baby's nose into his stomach. Expressed breastmilk is best, but if you can't express milk, don't worry, your baby will be given something else to keep up his sugar levels, probably formula milk.

Keep your baby near to you, preferably with skin-to-skin contact. This encourages breastfeeding. It also keeps your baby warm, which lowers the risk of hypoglycaemia. If the nursing or medical staff are worried about your baby's blood sugar level, the first thing they will ask you to do is try a feed. Breastmilk is best, if this is possible.

If your baby is breastfeeding, but his sugar levels are still a bit low, it can be difficult to decide if he should have a top-up of formula. The staff should talk this through with you. Get all the help you can to express your milk and get a supply going in the meantime, and to get your baby back on the breast as soon as possible. You may find some of the advice in our article on breastfeeding premature babies helpful.

If your baby's blood sugar level is quite low he will be seen by a paediatrician and will be given a sugar solution, or glucose, through a drip. Once your baby has stabilised, he can start taking feeds again and gradually come off the sugar drip. If your baby does not respond well to this treatment or if the hypoglycemia keeps happening, he will need tests to find out if a medical condition is causing it.

If my baby has hypoglycemia, can I still breastfeed?

If your baby is not feeding for a while because he is on a drip, it's important to keep your milk flow stimulated. You can do this by expressing milk frequently. Holding your baby close, with skin-to-skin contact, also helps. Most of the time, there is no reason why you can't eventually get your baby back on the breast, with a little help and advice.

Yes. When your baby gets hypoglycemia, it does not mean there is anything wrong with your breastmilk.